Introduction to Autism

Triad of Impairments

All people with an Autism Spectrum Disorder possess specific characteristics. These characteristic features are known as the triad of impairments.

1. Social Impairment

Impaired, deviant and extremely delayed social development, especially interpersonal development.

2. Language and Communication

Impaired and deviant language and communication - verbal and non-verbal.

3. Thought and Behaviour

Rigidity of thought and behaviour, and impoverished imagination.

Regardless of individual differences, anyone with an Autism Spectrum Disorder diagnosis will be impaired in all of these three areas.

Causes of Autism

Modern medical evidence suggests a biological causation. Evidence for a genetic component to autism seems very convincing.

However no study has shown evidence of one single abnormality present in everyone with autism. This would suggest that 'autism' is a broad diagnostic label, covering a lot of subgroups, all with potentially diverse aetiologies.

Prevalence of Autism

Autism Spectrum Disorders occur equally in all cultures and across all social classes. Dependent on criteria used to define autism, prevalence can be estimated at between 5 per 10,000 and 15 per 10,000. Potentially 85,000 people with an autistic spectrum disorder in the UK.

Currently there appears to be an increase in the number of cases of milder, high-functioning people with autism. Autism is 215 times more likely to occur in the siblings of people with autism than the general population.

There are approximately 4 males with autism for every female. However, although less frequent, autism is generally more severe in females.

Intelligence

There is a widely held view that children with autism are of normal intelligence, but cannot communicate due to their social and communication problems. Most hopes for a 'cure' are founded on this.

However studies show that only about 23% of people with autism would fall within the normal or near normal range of ability. In the remaining 77%, autism co-exists with a learning disability.

Asperger's Syndrome

Asperger never actually described the syndrome that now bears his name in the paper that he wrote. There is no common agreed definition of what Asperger's syndrome actually is, which can cause problems. You need to know whose definition you are using.

Researchers are currently debating about whether Asperger's syndrome and high-functioning autism are actually distinct from each other - and if so, how to distinguish them.

It is felt that:

People described as having Asperger's syndrome have more motor clumsiness than people with autism.
There is a higher family history of Asperger's syndrome.
People with Asperger's syndrome have pedantic speech patterns, lacking inflection.
They are poor at tailoring their conversation to social contexts.
They are more prone to mental illness, anxiety, depression and OCD.

Medication

Anticonvulsants:: About 30% of people with autism have epilepsy, and need to use anticonvulsants. Epilepsy often develops during adolescence.
Stimulants:: Stimulants or amphetamines (e.g. Dexedrine, Ritalin) can sometimes be helpful in reducing the hyperactivity that can accompany autism. However, some children actually deteriorate, others become sad and depressed.
Other Medication:: Antidepressants, neuroleptics, lithium, megavitamins - all used in attempts to treat people with autism. However, there is no single 'pill' to treat autism - but a range of medications, which can treat observed symptoms.
Self-Stimulation:: Usually occurs when fatigued, disorganised, confused. Legitimate response to situation.; The greater the person's understanding of what to do, what is going on, the less self-stimulatory behaviours occur.
Obsessive Behaviours:: Again, can create a 'comfort zone' in a scary, disorganised world. Also, people with autism may have neurochemical abnormalities associated with depression, mania and OCD.
Dislike Change:: People with autism like to do what they like to do.; Need for routine and order - high stress in new situations.; Temporal relationships.
Sequencing:: Poor understanding of sequencing, what happens next, consequences. Can lead to problems, e.g. sleep patterns.
Poor Generalisation:: Cannot generalise.; Learning/understanding is site specific. Can't transfer to a new situation.

Characteristics of Autism

Relatedness:: Relatedness to others is poor.; Interaction makes them anxious.; Empathy is lacking - do not understand emotions, feelings, needs of others.
Communication and Language:: Communication systems don't work.; Language often non-existent. If comes, can lack tone and inflection.; Language often echolalic.; Don't understand non-verbal cues, facial expression, and eye contact.; Understanding of world very concrete and literal.
Sensory Differences:: Use senses in a different way to the rest of us, often in self-stimulatory ways.
Hearing:: Seems to be unpredictable - sometimes not happening at all, then very acute.; Unable to filter out ambient and irrelevant noise.
Vision:: Strength of most people with autism. When familiar with something, often due to visual information.; Can focus well on visual detail.; Can also be used to self-stimulate - waving things in front of eyes use of peripheral vision.
Touch:: Many people with autism are tactile defensive.; Can be extremely sensitive (e.g. food textures, scratchy clothes).
Smell:: Often fascinated by smells, e.g. perfume, hairspray, deodorants ... and others!
Taste:: Will put tongues on things and taste things that may surprise us. May like strong tastes, (e.g. tomato ketchup), or only bland things.; Tooth and gum infections are common.

Alderwood LLA;